Recurrent laryngeal nerve management in transoral endoscopic thyroidectomy
DC Field | Value | Language |
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dc.contributor.author | Zhang, Daqi | - |
dc.contributor.author | Sun, Hui | - |
dc.contributor.author | Tufano, Ralph | - |
dc.contributor.author | Caruso, Ettore | - |
dc.contributor.author | Dionigi, Gianlorenzo | - |
dc.contributor.author | Kim, Hoon Yub | - |
dc.date.accessioned | 2021-08-30T15:14:48Z | - |
dc.date.available | 2021-08-30T15:14:48Z | - |
dc.date.created | 2021-06-18 | - |
dc.date.issued | 2020-09 | - |
dc.identifier.issn | 1368-8375 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/53302 | - |
dc.description.abstract | Introduction: The mechanism of recurrent laryngeal nerve (RLN) injury was investigated during a TransOral Endoscopic Thyroidectomy Vestibular Approach (TOETVA). Methods: The function of 185 nerves at risk (NAR) was recorded with intermitted intraoperative neural monitoring (I-IONM). The RLN electromyography (EMG) was delineated during: (a) a pre-dissection vagal nerve stimulation; (b) a RLN stimulation at initial visualization; (c) at nerve dissection; and (d) at the final verification of the entire RLN route. The location, genesis, segmental or diffuse and the outcomes of RLN injuries were catalogued. Results: Twelve nerves (6.4%) lost the EMG signal and the incidences of temporary and permanent RLN dysfunction were 5.9% and 0.5%. A disrupted point (type 1 injury) could be identified in 7/12 nerves (58%). Five (42%) nerve injuries were classified as global (type 2). Of the seven type 1 injuries, 3 lesions occurred at the RLN laryngeal entry point during the nerve identification. Four type 1 injuries were at the distal 1 cm of the RLN course and during the early nerve dissection. No proximal (> 2 cm) injuries occurred. The mechanisms of the injuries were thermal (58%) during the energy-based device use at the ligament of Berry dissection or at the dividing small branches of the inferior thyroid artery. Two (16%) traction injuries occurred during the early nerve dissection. In 2 cases we could not elucidate the mechanism of RLN injury (16%) and 1 injury (8%) was caused by the connective tissue constricting band of. The thermal RLN lesions had longer recovery times. Conclusions: The RLN palsy occurs in TOETVA, even when combined with an endoscopic magnification, IONM, early nerve identification, cranial to caudal dissection and top-down view. The thermal RLN injury was the most frequent cause and all injuries occurred at the distal RLN course. | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | ELSEVIER | - |
dc.subject | VESTIBULAR APPROACH | - |
dc.subject | ROBOTIC THYROIDECTOMY | - |
dc.subject | SURGERY | - |
dc.subject | SERIES | - |
dc.subject | OUTCOMES | - |
dc.subject | INJURY | - |
dc.subject | SAFETY | - |
dc.title | Recurrent laryngeal nerve management in transoral endoscopic thyroidectomy | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Kim, Hoon Yub | - |
dc.identifier.doi | 10.1016/j.oraloncology.2020.104755 | - |
dc.identifier.scopusid | 2-s2.0-85086654157 | - |
dc.identifier.wosid | 000566724700005 | - |
dc.identifier.bibliographicCitation | ORAL ONCOLOGY, v.108 | - |
dc.relation.isPartOf | ORAL ONCOLOGY | - |
dc.citation.title | ORAL ONCOLOGY | - |
dc.citation.volume | 108 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Oncology | - |
dc.relation.journalResearchArea | Dentistry, Oral Surgery & Medicine | - |
dc.relation.journalWebOfScienceCategory | Oncology | - |
dc.relation.journalWebOfScienceCategory | Dentistry, Oral Surgery & Medicine | - |
dc.subject.keywordPlus | VESTIBULAR APPROACH | - |
dc.subject.keywordPlus | ROBOTIC THYROIDECTOMY | - |
dc.subject.keywordPlus | SURGERY | - |
dc.subject.keywordPlus | SERIES | - |
dc.subject.keywordPlus | OUTCOMES | - |
dc.subject.keywordPlus | INJURY | - |
dc.subject.keywordPlus | SAFETY | - |
dc.subject.keywordAuthor | Thyroidectomy | - |
dc.subject.keywordAuthor | Transoral thyroidectomy | - |
dc.subject.keywordAuthor | Transoral endocrine surgery | - |
dc.subject.keywordAuthor | Transoral endoscopic thyroidectomy vestibular approach | - |
dc.subject.keywordAuthor | TOETVA | - |
dc.subject.keywordAuthor | Morbidity | - |
dc.subject.keywordAuthor | Neuromonitoring | - |
dc.subject.keywordAuthor | Recurrent laryngeal nerve | - |
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